Former Michigan State University and USA Gymnastics doctor Larry Nassar gives an impact statement during the sentencing phase in Ingham County Circuit Court on Jan. 24, 2018 in Lansing.(Photo: Jeff Kowalsky/AFP/Getty Images)

"I just signed your death warrant," Aquilina said Wednesday in Ingham County Circuit Court, where she sentenced Nassar to 40 to 175 years in prison as part of a plea deal on seven counts of first-degree criminal sexual conduct involving more than 160 girls and women over more than two decades.

Nassar — the once-acclaimed sports medicine doctor who traveled the world with the U.S. Olympic team, and treated athletes from Michigan State University to USA Gymnastics to private gyms — deceived athletes over more than two decades, manipulating them into believing sexual assault was medical care.

The first woman to speak publicly about the molestation she suffered at the hands Nassar was the last to give a victim-impact statement during the sentencing hearing Wednesday that sealed his fate.

Rachael Denhollander, who began seeing Nassar when she was a 15-year-old gymnast, was the first to allow her name to be used in interviews with the Indianapolis Star following its 2016 exposé about sexual abuse at USA Gymnastics.

"The truth about what Larry has done must be realized to its fullest depth if justice is to ever be served," she told the court.

"Larry meticulously groomed me for the purpose of exploiting me for his own sexual gain. He penetrated me. He groped me. He fondled me, and then he whispered questions about how it felt. He engaged in degrading and humiliating sex acts without my consent or permission. And Larry enjoyed it. Larry sought out and took pleasure in little girls and women being sexually injured and violated because he liked it.

"What was done to myself and these other women and little girls and the fact that our sexual violation was enjoyed by Larry matters. It demands justice, and the sentence you impost today sends a message about how much these precious women and children are worth."

Aquilina praised the courage of Denhollander and all the girls and woman who stood up in court to tell their stories during seven days of victim-impact statements

"Justice requires an action and a voice," Aquilina said, adding that those survivors were "168 buckets of water on your so-called match that got out of control.

"There has to be a massive investigation as to why there was inaction, why there was silence. Justice requires more than what I can do on this bench.

"Your decision to assault was precise, calculated, manipulative, devious, despicable. ... You can't give them back their innocence, their youth. You can't give a father back his life, or one of your victims back her life when she took it. You can't return the daughter to the mother, the father to the daughter. ... It is my honor and privilege to sentence you, because sir you do not deserve to walk outside a prison ever again."

Nassar addressed the courtroom, apologizing to the girls and women he hurt over the years.

"Your words these past several days, your words, your words, have had a significant emotional impact on myself and have shaken me to my core," he said. "There are no words that can describe the depth and breadth for how sorry I am for what has occurred.

"An acceptable apology to all of you is impossible to express or convey. I will carry your words with me for the rest of my days."

Denhollander had this warning to all who have children and young women in their care:

"This is what it looks like when the adults in authority do not respond properly to disclosures of sexual assault," she said. "This is what it looks like when institutions create a culture where a predator can flourish unafraid and unabated.

"And this is what it looks like when people in authority fail to listen, put friendships in front of the truth, fail to create or enforce proper policy and fail to hold enablers accountable.

"This is what it looks like. It looks like a courtroom full of survivors who carry deep wounds. Women and girls who have banded together to fight for themselves because no one else would do it. Women and girls who carry scars that will never fully heal, but who have made the choice to place the guilt and shame on the only person to whom it belongs, the abuser."

"Was it the right way or the wrong way," Rachael Denhollander says as she addresses Circuit Judge Rosemarie Aquilina about Michigan State University's response to allegations of sexual abuse, Wednesday, Jan. 24, 2018, during the sixth day of victim impact statements in Ingham County Circuit Court. Nassar is expected to be sentenced on seven sexual assault charges today.(Photo: MATTHEW DAE SMITH/Lansing State Journal)